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PSOM: "glue ear" in cavaliers

Primary secretory otitis media or PSOM has emerged as a health issue within the cavalier breed. The condition is similar to "glue ear" in human children, where a gluey, mucous plug forms in the middle ear and can cause hearing difficulty, up to total deafness but also, anything from mild discomfort expressed as scratching at the ears, to extreme pain including seizures and other neurological problems.

Many of the symptoms of PSOM are similar to those for syringomyelia (see http://www.cavaliertalk.com/phpBB2/viewtopic.php?t=25 ) so a vet or neurologist looking for possible SM should also check for PSOM as an alternative or simultaneous presence. PSOM does show up on MRI but the ear can also be examined with a special scope under general anaesthesia. The mucous plug can be flushed from the ear but often this procedure must be repeated more than once to be successful. Neurologists who regularly do MRIs on cavaliers say some degree of PSOM is often present. Many neurologists and vets advise leaving the condition unless it is causing distress or severe deafness, as the flushing procedure is invasive, requires anaesthesia, and has some potential though rare complications. Be sure to ask your vet or neurologist to talk through these aspects of treating PSOM.

Below is the abstract of a detailed paper written on PSOM in cavaliers. The full article runs to about 5 pages and is not difficult to understand for a general reader. If you suspect PSOM you may wish to purchase the article online and print it out for your vet.

Abstract:
Sixty-one episodes of primary secretory otitis media (PSOM) were diagnosed in 43 Cavalier King Charles spaniels over a 10-year period. The principal findings were signs of moderate to severe pain localised to the head or cervical area, and/or neurological signs. Diagnosis was made by examination of the tympanic membrane and middle ear with the aid of an operating microscope under general anaesthesia. A bulging, but intact, tympanic membrane was found in most cases. Following myringotomy, a highly viscous mucus plug was found filling the middle ear. Treatment, consisting of removal of the mucus plug, flushing of the middle ear, and local and systemic medical therapy, had to be repeated between one and five times. The prognosis was good in all cases. PSOM is an important differential diagnosis in Cavalier King Charles spaniels with signs of pain involving the head and neck, and/or neurological signs.